Client Accountability and Assessment, Assessment in Recreation Therapy, Psychometric Assessment: Reliability and Validity

Accountability

Delivering the 'right' service to the 'right' client at the 'right' time

Assessment

1. Prerequisite to providing appropriate interventions to clients. 2. Critical part of documenting and defending the efficacy of services. 3. Required for reimbursement. 4. Provides credibility to other professionals.

Objective

When two people can come up with the same results.

Subjective

More personal - a thought, feeling, or something in the person's mind. Different people assessing could come up with different information.

Nonstandardized Assessment

Tools not tested for effectiveness, tailored to facility/need, therapist's interpretation key, helpful for non-covered elements, can be used with other assessments

Standardized Assessment

Systematic, tested for validity and reliability, well-defined and limited in measurement, used for tracking data

Nominal Data

Doesn't measure but categorizes, e.g., 'Are you in school?'

Attitudinal Data

Measures ways of thinking, feeling, acting

Functional Data

Observable/measurable information falling into 7 categories

Summary of Findings

Based on clinical opinion

Proposed Treatment Direction

Treatment plan based on assessment

RAI (Rapid Assessment Instruments)

Standardized screening, brief design, used for further assessment or monitoring

Signs

Warnings of something wrong

Scales

Measure 'where' or 'how much' in increments

Classical Test Theory

Every individual testable for any specific attribute, observed score = true score + error

Generalizability Theory

Making decisions about client's abilities across similar unmeasured areas

Item Response Theory

Client's performance on each item is more important than total score

Taxonomy

Classifying behaviors in cognitive, physical, and emotional domains

Bloom's Taxonomy

A classification of the different objectives that educators set for students

Cognitive Domain

The area of learning that involves the development of intellectual skills and knowledge

Knowledge

Recalling or recognizing information, such as defining or listing

Comprehension

Understanding meaning and re-stating data in one's own words

Application

Applying knowledge to real circumstances or putting theory into practice

Analysis

Interpreting elements, organizational principles, and internal relationships

Synthesis

Developing new unique structures, systems, models, or ideas

Evaluation

Assessing the effectiveness of concepts and critical thinking

Affective Domain

The area of learning that involves attitudes, feelings, and emotions

Receive

Being open to experience and willing to hear, such as listening and focusing

Respond

Reacting and participating actively, seeking clarification and providing examples

Value

Attaching values and expressing personal opinions, debating and justifying

Organize or Conceptualize

Reconciling internal conflicts and developing a value system

Characterize

Acting consistently in accordance with internalized values

Psychomotor Domain

The area of learning that involves physical movement and coordination

Imitation

Watching and repeating actions or processes

Manipulation

Carrying out tasks from written or verbal instructions

Precision

Performing a task with expertise and high quality without assistance

Articulation

Adapting and integrating expertise to satisfy non-standard objectives

Naturalization

Automated, unconscious mastery of activity and related skills at a strategic level

Norm-referenced

Measures compared to a larger group, representative of the group

Criterion Referenced

Measures absolute ability to do a task based on individual competence

Transtheoretical Model of Behavior Change

A theory that describes the stages of behavior change and the processes people go through to bring about successful change

Positive Psychology

A scientific approach to studying human thoughts, feelings, and behavior with a focus on strengths instead of weaknesses

Broaden and Build Model

A theory that suggests positive emotions broaden an individual's mindset and build personal resources

Social Cognitive Theory

A theory that emphasizes the role of observational learning, imitation, and modeling in behavior change

Cognitive-Behavioral Approach

A method used to change a client's thoughts, feelings, and behaviors, emphasizing personal control and competence

Self Efficacy

The amount of effort and persistence a client is likely to have based on outcome expectancy and expectations

Efficacy Beliefs

Individual's confidence in successfully engaging in behavior

Stage Definition Tasks

Pre-contemplation, Contemplation, Preparation, Action, Maintenance, Integration stages of behavior change with corresponding tasks

Health Locus of Control Scale

Assessment based on Social Learning Theory to measure beliefs about control over health

Alcohol Abstinence Self-efficacy Scale

Assessment to measure confidence in abstaining from alcohol

Weight Efficacy Life-Style Questionnaire

Assessment to measure confidence in managing weight and lifestyle

Eating Self-Efficacy Scale

Assessment to measure confidence in controlling eating habits

Exercise Self-efficacy Scale

Assessment to measure confidence in maintaining an exercise routine

International Classification of Functioning, Disability, and Health (ICF)

Framework for understanding how health conditions relate to functioning and disability beyond diagnosis

ICF Classification

Coding system for health conditions affecting body structure/function, activities, participation, and environmental factors

ICF Qualifiers

Performance and capacity qualifiers indicating the level of difficulty/problems in functioning

RT

Refers to Recreational Therapy, uses codes for clinical decision-making

Psychometric

Measurement of behaviors and thought processes

Reliability

Consistency and stability of an assessment tool

Validity

Accuracy; degree to which an assessment reflects the underlying construct

Consistency

Reliability; repeatability or replicability of findings and instruments

Accuracy

Validity; extent to which an assessment reflects the underlying construct

Repeatability

Reliability; consistency of findings and instruments over time

Test-retest

Administering a test or instrument twice to obtain consistent results

Split-half Reliability

Comparing responses to items in a test to measure internal consistency

Correlation Coefficient

Relationship between two different things, used to determine reliability and validity

Internal Validity

Whether the instrument measures what it says it does and is free of bias

External Validity

Generalizability of results beyond the individual to a group of individuals

Correlation

Statistical score indicating the relationship between two variables

Precision

Measures the phenomenon in fine detail, a feature of validity

Voluntary Standards

Standards set by accreditation organizations such as Joint Commission and CARF

Professional Standards

Standards set by professional organizations like ATRA

Site Specific Standards

Regulatory standards for specific facilities or sites

Screening

Assessing for problems and patterns to inform/improve patient treatment plan

Referral

Initiation of services by a physician or relevant clinician based on assessment

Principles of Assessment

A systematic process yielding dependable and consistent results to inform interventions

Rehabilitation Measures Database

Online resource to discover assessments for clients with various needs

What is a good score for validity?

Greater than .3

Clinical evaluation

The value placed on client attributes to create change based on the assessment

What is the theory used in RT where clients are anticipated to be able to learn from other individuals?

Social cognitive theory

What are the organizations under voluntary that set standards?

CARF, JCAHO, CMS

What is the classical test theory?

The total score is taken into account with the error to give an observed score, (observed score = true score + error)

The level of Bloom's Cognitive Taxonomy where some could locate information about their leisure interests

Comprehension

This is harder to obtain in psychometrics

Validity

What is norm-referenced?

The assessment is interpreted based on average scores of that person's peer or comparison group.

This theory is used by RT to "undo" negative perceptions.

The broaden and build theory

The assessment instrument (_______) is measuring what it is intended to measure

validity

Unit Coverage

Every pt of the facility gets served by the RT

What is the purpose of client assessment?

To place client in programs based on their needs

The theory that underlies many RT interventions and results in greater connection between feelings, behavioral intentions, and actual behaviors for a client.

Cognitive Behavioral Change Theory

What is the starting point of measuring pt. behaviors

"baseline of assessments"

The instrument yields accurate information about the client in terms of consistency

Reliability

Policy and procedures manual

In a facility where they have their own standards on assessments listed

location of many assessment to use

rehab measure data base

answers the question of how stable the assessment instrument is over a given period of time

test-retest reliability

in a facility where they have their own standards on assessments listed

policy and procedures manual

good score for validity

greater than .3

definition of clinical evaluation

value placed on client attributes to create change based on the assessment

theory used in Rt where clients are anticipated to be able to learn from other individuals

social cognitive theory